Getting better or worse? How trends in healthy life expectancy within working age are shaped by diverging trends among age groups.

Against the backdrop of population ageing and growing labour shortage, Healthy Life Expectancy (HLE) in working age represent a key resource for individual wellbeing and economic growth. This study investigates how age-specific trends shape the development of HLE within working age and whether these trends differ between health indicators. We used the German Socioeconomic Panel to calculate HLE between age 18 and 64 for three periods between 2002 and 2022 (N = 232 393) based on Self-rated Health (SRH), mental and physical Health-related Quality of Life (p/mHRQoL). We decomposed changes in HLE over time into the contributions by age group and distinguished between morbidity and mortality contributions. For men, HLE increased in terms in SRH but remained largely unchanged in terms of mHRQoL and pHRQoL. For women, HLE decreased in terms of SRH and pHRQoL while it remained stable for mHRQoL. Deteriorating health in younger working-age groups strongly contributed to decreases in HLE while improving health at older working age fostered increases in HLE. Mortality contributions were minor. We found divergent contributions to trends in HLE by age group with the younger working-age population fostering decreases in HLE while older age groups fostered an increase. Furthermore, trends differed by health indicator, which underlines the importance of analysing more than one indicator whenever possible. The findings are worrying and suggest that the labour force may decline not only due to population ageing, but also due to the deteriorating health, posing growing challenges for both health and labour market policies.